Anyone who’s read Old Yeller knows (spoiler alert!) what happens to the title dog in the book. In this day of vaccinations against rabies, though, many people don’t give rabies more than the thought required to take their pets to the vet.

Yet rabies is still around, present in many mammals, including raccoons, skunks, bats, and foxes, and contact with any infected animal can mean infection for you or an unvaccinated furry pet.

Rabies is a viral disease. The virus attacks the central nervous system—the brain and spinal cord—and eventually is fatal (although there are extremely rare cases of survival). Symptoms, according the Centers for Disease Control and Prevention, are non-specific in the beginning—a fever, a headache, a general feeling of being unwell. But eventually, they progress to neurological symptoms, including hallucinations, confusion, paralysis, difficulty swallowing, and hydrophobia (as the disease is called in Old Yeller). Once these symptoms are present, death is only days away.

Usually, rabies is transmitted through a bite, transferred via the saliva of the infected animal, although rarely it transfers through other routes, such as via the air or transplantation of infected organs. The virus itself triggers no symptoms for up to 12 weeks even as it multiplies and invades the brain and spinal cord. When symptoms finally show up, an infected organism dies within about seven days.

Vaccines against rabies are available for animals, but worldwide, dogs remain the most common source of rabies infection in people, and children are at greatest risk. Vaccination could reduce or eliminate this risk, and a goal of the World Rabies Day campaign is to ensure more widespread vaccination of dogs. Since the campaign began in 2007, 4.6 million dogs have been vaccinated thanks to awareness events. This year’s goal is to grow that number even more.

Vaccinations also exist for people, especially post-exposure vaccinations. They once had a dire reputation as painful shots administered in the stomach, but now they’re shots in the arm and no more painful than other vaccinations. These shots include a shot given the day of exposure followed by more shots in an arm muscle on days 3, 7, and 14, according to the CDC. However, there is a short window of time for these vaccines to be effective; they must be administered preferably within a day of exposure. For people who have already had rabies vaccinations, a briefer round of further shots is required.

Indeed, the disease gets a mention from ancient luminaries such as Aristotle and Celsus, but it wasn’t until the 19th century that Louis Pasteur developed a way of preventing the disease in animals, taking nerve tissue from infected rabbits and drying it out to weaken the virus for use in a vaccine. On July 6, 1885, Pasteur tried his vaccine out in a young boy who had suffered a bite from a rabid dog. The boy lived and did not develop rabies. The vaccine had been a success.

This breakthrough led to development of a vaccine for animals and a preventive vaccine for humans who had been bitten by animals suspected or confirmed to have rabies. Yet, the disease remained a fear well into the 20th century, a featured element in American literature from Old Yeller to To Kill A Mockingbird.

Even today, with widespread vaccine campaigns targeting domestic pets, rabies persists in some wild populations, such as bats, where infection rates run about 6%. Where bats occur, health officials struggle to keep the public informed, warning that no bat should ever be touched or handled because of the risk of rabies transmission. Exposure to bats can kick up during the summer months when people are outdoors more. One study found that 46% of rabies-related bites came from bats, and the huge majority of these infectious bites occur during the summer months.

Other wild animals that carry rabies include foxes, raccoons, skunks, and coyotes. And even though only 27 cases of confirmed infection have been reported in people in the United States since 1990, every year between 16,000 and 39,000 people receive treatment because of suspected exposure.

Until recently, anyone who was exposed had to undergo a series of five shots to avoid developing the disease, which is almost invariably fatal. That series can now be reduced to four.

While vaccines were once based on virus grown in nervous system tissue, today’s vaccines are instead grown in cells in culture.

It’s pretty straightforward to avoid contracting rabies, but children in particular need to be educated about the rules: avoid contact with all wild animals known to transmit the disease, including bats, foxes, coyotes, and skunks. Never touch or approach an injured animal, and if you have a domesticated pet, such as a dog or cat, be sure that Spot or Fifi is completely up to date on all vaccines.

Disclaimer

The information on PKIDs' Blog is for educational purposes only and should not be considered to be medical advice. It is not meant to replace the advice of the physician who cares for you or your child. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.